The thesis work comes from the experience of the association La Parola Magica from Milano which, in agreement with CiaoLapo from Prato, gave birth in October 2015 to the Alchimia project, aimed at helping the bereaved parents who have lost their child during the perinatal age (from the 27th week of pregnancy to 10 days after birth). To date the project has included 80 subjects and is open to parents who come not only from the CiaoLapo network but also from the Milan hospitals, in particular from the Niguarda Ca’ Granda Hospital. The course explores the following themes: - perinatal grief in all its aspects; from the health one, to the points of view of the couple, individual, society and coping both in hospital and in other places such as family, associations, community and wider society. On this topic, an analysis of international scientific research, able of exemplifying the state of the art is being conducted. The analysis of the typology of the event and the psychological dynamics connected to it, is dealing specifically with the theme of trauma as the fundamental component of perinatal loss. In relation to the traumatic connotations of the event, the supporting literature demonstrates the need to promptly intervene with the couple in order to prevent the onset of disorders such as post-traumatic stress disorder and major depression; - The mourning coping is analyzed, focusing on the actions in the following areas: a) hospital and socio-sanitary territorial services in the acute and subacute phase, targeted at the child, the woman, the man, the couple and/or family in case there are other children; b) social / community with particular attention to the model of the self-help group facilitated by the theoretical exploration of the theme and the reconstruction of the international scenario of use of this device; - The specific project of Milan, which provides for the integration of more professionals (gynecologist, psychotherapist, psychologist, counselor) and more actions in support of parents and hospital operators. The project puts in place direct actions for parents such as interventions in hospital agreed with the institution, interviews, mutual support groups, expressive, ritual and symbolic activities and indirect actions of referring to other professionals for interventions on health-related topics. For hospital operators, support actions are implemented in the acute phase directly in the hospital. Finally, for the purposes of raising awareness and promoting knowledge in enlarged contexts, the project moves in the institutional (Municipality of Milan) and academic (Statale University) areas with cultural /training actions (organization of conferences and activation of lessons); - the analysis of a clinical case A couple of parents already included in the self-help group at a medium temporal distance from the event (the literature indicates two years as the maximum time for processing out of the mourning) has been included in the group of "body expressiveness”. This group allows a bodily-ritual-symbolic experience aimed at processing the experience of the loss in the internal space of the individuals and in the couple relationship. The analysis of the clinical case has its roots in the deepening of the biosystemic method and its applications in the group sphere. The interviews, carried out after two months after working with the parents, confirm the positive effects of the body work done; - The guidelines for a future development that, starting from the problematic nodes and the highlighted resources and strengths, trace some hypotheses and useful proposals in the perinatal mourning area.
il lavoro di tesi si muove dall’esperienza dell’associazione La Parola Magica di Milano che in convenzione con CiaoLapo di Prato ha dato vita dall’ottobre 2015, al progetto Alchimia finalizzato ad accompagnare i genitori in lutto per la perdita del loro bambino in epoca perinatale (dalla 27 settimana a 10 giorni dopo la nascita). Il progetto, a oggi, ha visto l’inserimento di 80 soggetti ed è aperto a genitori che arrivano non solo dalla rete di CiaoLapo ma anche dagli ospedali milanesi in particolare dall’Ospedale Niguarda Ca’ Granda.Il percorso esplora i seguenti temi: - il lutto perinatale in tutti i suoi versanti quindi dal punto di vista sanitario, soggettivo, di coppia, sociale e del fronteggiamento sia in ospedale che in luoghi altri come la famiglia, l’associazionismo, la comunità e la società allargata. Su questo tema viene condotta un’analisi delle ricerche scientifiche in ambito internazionale in grado di esemplificare lo stato dell’arte. Nell’analisi della tipologia dell’evento e delle dinamiche psicologiche ad esso connesse, si tratta in specifico, il tema del trauma componente fondamentale della perdita perinatale. In relazione alle connotazioni traumatiche dell’evento, viene indicata e dimostrata dalla letteratura a supporto, la necessità di intervenire tempestivamente con la coppia in modo da scongiurare l’insorgenza di disturbi quali il disturbo post traumatico da stress e la depressione maggiore; - Il fronteggiamento del lutto vengono analizzate in particolare le azioni nei seguenti ambiti: a) ospedaliero e dei servizi socio-sanitari territoriali in fase acuta e subacuta rivolte al bambino, alla donna, all’uomo, alla coppia in quanto tale e alla famiglia nel caso ci fossero altri figli; b) sociale/comunitario con particolare attenzione al modello del gruppo di auto mutuo aiuto facilitato con l’esplorazione teorica del tema e la ricostruzione del scenario internazionale di utilizzo di tale dispositivo; - Il progetto specifico di Milano che vede l’articolazione e l’integrazione di più professionisti (ginecologo, psicoterapeuta, psicologo, counselor) e più azioni a sostegno dei genitori e degli operatori ospedalieri. In specifico, sul versante genitori, mette in campo azioni dirette nella forma dell’intervento in ospedale concordato con l’ente, del colloquio, del gruppo di auto-mutuo e dell’esperienza in gruppo di tipo espressivo, rituale e simbolico e azioni indirette di invio a professionisti in rete per interventi su temi afferenti di tipologia sanitaria. Sul fronte operatori ospedalieri, vengono attuate azioni di sostegno in fase acuta quindi direttamente in ospedale. Infine, a fini di sensibilizzazione e promozione della conoscenza in contesto allargato, si muove in ambito istituzionale (Comune di Milano) e accademico (Università Statale) con azioni di tipo culturale/formativo (organizzazione di convegni e attivazione di insegnamenti); - L’analisi di un caso clinico. Una coppia di genitori già inserita nel gruppo di auto-mutuo aiuto a una distanza temporale media dall’evento (la letteratura indica come tempo massimo per elaborazione uscita dal lutto l’arco temporale dei due anni) è stata inserita nel gruppo di “espressività corporea” per un’esperienza di tipo corporeo-rituale-simbolico finalizzata a promuovere la collocazione dell’esperienza della perdita nello spazio interno dei soggetti e relazionale della coppia. L’analisi del caso clinico si struttura a partire dall’approfondimento del metodo biosistemico e delle sue applicazioni in ambito gruppale. Il colloquio a distanza di due mesi dal lavoro effettuato con i genitori conferma le ricadute positive del lavoro corporeo effettuato; - Le linee di sviluppo futuro che a partire dai nodi problematici e dalle risorse e punti di forza evidenziati, tracciano alcune ipotesi e proposte di sviluppo utili nell’ambito del lutto perinatale.
IL FRONTEGGIAMENTO PSICOSOCIALE DEL LUTTO PERINATALE
MARAZZI, CHIARINA
2016/2017
Abstract
The thesis work comes from the experience of the association La Parola Magica from Milano which, in agreement with CiaoLapo from Prato, gave birth in October 2015 to the Alchimia project, aimed at helping the bereaved parents who have lost their child during the perinatal age (from the 27th week of pregnancy to 10 days after birth). To date the project has included 80 subjects and is open to parents who come not only from the CiaoLapo network but also from the Milan hospitals, in particular from the Niguarda Ca’ Granda Hospital. The course explores the following themes: - perinatal grief in all its aspects; from the health one, to the points of view of the couple, individual, society and coping both in hospital and in other places such as family, associations, community and wider society. On this topic, an analysis of international scientific research, able of exemplifying the state of the art is being conducted. The analysis of the typology of the event and the psychological dynamics connected to it, is dealing specifically with the theme of trauma as the fundamental component of perinatal loss. In relation to the traumatic connotations of the event, the supporting literature demonstrates the need to promptly intervene with the couple in order to prevent the onset of disorders such as post-traumatic stress disorder and major depression; - The mourning coping is analyzed, focusing on the actions in the following areas: a) hospital and socio-sanitary territorial services in the acute and subacute phase, targeted at the child, the woman, the man, the couple and/or family in case there are other children; b) social / community with particular attention to the model of the self-help group facilitated by the theoretical exploration of the theme and the reconstruction of the international scenario of use of this device; - The specific project of Milan, which provides for the integration of more professionals (gynecologist, psychotherapist, psychologist, counselor) and more actions in support of parents and hospital operators. The project puts in place direct actions for parents such as interventions in hospital agreed with the institution, interviews, mutual support groups, expressive, ritual and symbolic activities and indirect actions of referring to other professionals for interventions on health-related topics. For hospital operators, support actions are implemented in the acute phase directly in the hospital. Finally, for the purposes of raising awareness and promoting knowledge in enlarged contexts, the project moves in the institutional (Municipality of Milan) and academic (Statale University) areas with cultural /training actions (organization of conferences and activation of lessons); - the analysis of a clinical case A couple of parents already included in the self-help group at a medium temporal distance from the event (the literature indicates two years as the maximum time for processing out of the mourning) has been included in the group of "body expressiveness”. This group allows a bodily-ritual-symbolic experience aimed at processing the experience of the loss in the internal space of the individuals and in the couple relationship. The analysis of the clinical case has its roots in the deepening of the biosystemic method and its applications in the group sphere. The interviews, carried out after two months after working with the parents, confirm the positive effects of the body work done; - The guidelines for a future development that, starting from the problematic nodes and the highlighted resources and strengths, trace some hypotheses and useful proposals in the perinatal mourning area.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/10866